MEDICARE: MRS. SAMANTHA MEHERUN SARWAR MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1720697287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SAMANTHA MEHERUN SARWAR MSW

Provider Business Mailing Address
First Line	:	19721 E COUNTRY HOLLOW DR
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-5306
Country	:	US
Telephone Number	:	909-527-5744
Fax Number	:

Provider Business Practice Location Address
First Line	:	9322 BURNET AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-2305
Country	:	US
Telephone Number	:	909-527-5744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	07/30/2020

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